Flexclinics, a private clinic for orthopaedic surgical procedures in Spain

by Lorraine Williamson
Hospital Ceram

Flexclinics is known as an independent treatment centre (ZBC) in the Netherlands for orthopaedic and plastic surgery. Since September 2022, patients can also now undergo orthopaedic procedures in Marbella (Malaga), Spain.

Orthopedist Joris Van der Lugt works together with Peter van Aggelen both in the Netherlands and in Spain. Van Aggelen is an anesthesiologist and also the founder and director of Flexclinics. InSpain.news spoke with Peter, who founded the clinic together with Marc Verheyen. Both found there was a strong need to be able to provide high-quality, small-scale and quicker care. Something that, in their view, is increasingly lacking in the Netherlands, where economies of scale and hospitals have turned into unwieldy factories, as a result of which patients have to wait longer for care. 

Independent treatment centre as the future 

An independent treatment centre such as Flexclinics, is the future in health care according to Peter. “As I’ve been saying for 12 years; anything that’s elective and can be planned should go out of the hospital. For example, Hospital Ceram in Marbella has grown from fertility treatment and they provide that obstetric care in a private clinic. Give me one reason why that would not be possible in the Netherlands or elsewhere.” 

“Care on a human level” 

“With Flexclinics we want to offer care at a human level. When patients call us, they don’t get a computer, but can always speak to a real person on the phone. Each patient is linked to someone from our back office and can answer questions during office hours,” says Peter. He also emphasises that Flexclinics in the Netherlands is small-scale and personal with two operating rooms and six private rooms with spacious bathrooms. It employs six orthopaedic surgeons, one plastic surgeon and two anaesthesiologists. They often also work partly in other hospitals, so that they can keep in touch with the more complex issues that are not suitable for treatment in a independent treatment centre. 

Waiting times of less than two weeks 

Peter started as an anaesthesiologist in the Franciscus Gasthuis in Rotterdam. He also took part in many military deployments. After 18 years, he says he was done with all the politics and bickering about money and mergers. He switched to ZBC Bergman Clinics, which now has branches throughout the Netherlands, and also in Germany and Scandinavia. “This growth is now also causing longer waiting times at that clinic. Partly due to the much wider waiting time problem, more and more people are finding their way to Flexclinics. In the Netherlands, we generally have waiting times of less than two weeks for orthopaedic interventions,” emphasises Peter. 

Flexclinics in Marbella 

At Flexclinics in the Netherlands, patients can go for a wide range of orthopaedic procedures including hip, knee, shoulder and hand/wrist surgery as well as plastic surgery. For the time being, only Joris van der Lugt operates in FlexClinics in Marbella, Spain. Here, Flexclinics works together with Hospital Ceram in the Spanish seaside resort. Joris van der Lugt also gives consultations at Cenyt Hospital in Estepona and is already operating there for Spanish patients covered through Spanish insurers.

Orthopaedic procedures in Marbella

 This spring, more orthopaedists from Flexclinics will come to Spain to operate. The first is Jan Willem van Ommeren, he is scheduled in January with a consultation hour for knee complaints in particular, both for knee prosthesis and also for cruciate ligament and meniscus injuries, such as those that can occur in athletes, among others. Jantine Posthuma de Boer is also working on her registration in Spain. She specialises in elbows, hands and wrists. 


Insurance issues 

In Spain, Flexclinics mainly targets expats and others who are insured in foreign countries like the Netherlands, the UK or Scandinavia, or who are willing to pay for an operation themselves (or to pay extra if the insurer reimburses part of it) because they want to get rid of their pain as quickly as possible. For operations in Spain, it depends on the health insurer and the policy conditions whether and to what extent the operation is reimbursed. Flexclinics is happy to find this out together with the patient,” explains Peter. 

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Digital patient screening 

Anyone who needs a new knee or hip, or needs to undergo a revision of a prosthesis or has another orthopaedic problem, can contact Flexclinics. This is followed by an appointment with the surgeon. The surgeon assesses whether the patient can be operated on. If so, there will be a digital questionnaire the patient must complete via e-POS (Novaair®), which is available in English and four other languages. This questionnaire forms the basis for the anaesthesiologist to estimate the risk. Peter explains that this screening is scientifically substantiated and gives Flexclinics the opportunity to work remotely digitally. As a result, the clinic can operate worldwide, but also more efficiently and save on time and personnel.  

“If we want additional information after the electronic screening, we talk to the patient ourselves. Or, of course, if the patient prefers, he or she can indicate this in the questionnaire. For those people, I really have the time to assess the possible risks of an operation and answer questions,” Peter explains. Peter van Aggelen

Peter has been working with Joris for years and has great confidence in him. “When Joris says that something will take longer or that there may be blood loss, that is always right. This is very important for us anaesthesiologists. Not only do we have a risk assessment for the patient, but I also have to be able to trust the operator. Joris is one of the best orthopedists I know”. 

Why Flex Clinics? 

For those who are unsure about a possible operation at Flexclinics in Spain, Peter has a question: “What do you find important: a good operator and guaranteed quality for something further away or staying close to home and waiting much longer?” The anesthesiologist explains: “Flexclinics works exclusively with the best Dutch surgeons, supported by the best Dutch nursing and support staff. In order to guarantee the quality, the doctors also work with only high-quality certified materials. We do the follow-up checks either locally or by telephone. For Spain, we look at the insurance options in advance”. Another advantage of being operated in Spain is a possible revalidation in a nicer climate. In this sens Flexclinics also can give the patient advice.

Dutch quality postoperative physiotherapy 

These follow-up checks take place to see how the rehabilitation is going. Usually, there is a longer rehabilitation after knee surgery. With a new hip, you can walk quite easily with two sticks on the same (!) day. This also works with a new knee, even if it takes a little more time for recovery afterwards. “We do know that the sooner you start exercising, even against the pain, the better the long-term recovery will be. You have to practice well and not sit still because it hurts. Postoperative physiotherapy is very common in the Netherlands, but not at all in Spain. In Marbella, we work together with the Dutch physiotherapist Robine van den Berge, who was educated in the Netherlands, because we also wanted to offer Dutch-quality physiotherapy in Spain.”

Do you want to know more? Check out the website of Flexclinics in English or send an e-mail to info@flexclinics.nl. 


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